NPIMap

Individual provider Active NPI

Betsy Jo Bolton, PA-C

  • Surgical Physician Assistant
  • Clive, IA
National Provider Identifier
1144574997
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
002351 Issued in IA
Practice address
12499 University Ave Ste 210
Clive, IA 50325-8288
Phone
(515) 440-2676
Fax
(515) 440-2677
NPI assigned
Nov 1, 2012
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002351 IA
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 002351 IA Primary

Addresses

Primary practice location

12499 University Ave Ste 210
Clive, IA 50325-8288

Mailing address

2425 Westown Pkwy Ste 100
West Des Moines, IA 50266-1425
Phone (515) 267-1819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130128000426 IA Practitioner - Physician Assistant 2567616550 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Community Hospital IncGroup PAC ID 6608787056, 34 clinicians
Capital Orthopaedics and Sports Medicine PCGroup PAC ID 3476691551, 19 clinicians
Broadlawns Medical CenterGroup PAC ID 3678466166, 302 clinicians

Practice addresses (Care Compare)

1002 S Lincoln St
Knoxville, IA 50138-3155

1202 W Howard St
Knoxville, IA 50138-3103
Phone (641) 828-7211

12499 University Ave
Suite 210
Clive, IA 50325-8288
Phone (515) 440-2676

1801 Hickman Rd
Des Moines, IA 50314-1548
Phone (515) 282-2200

1801 Hickman Rd
Des Moines, IA 50314-1597

2222 Philadelphia St
Ames, IA 50010-8700
Phone (515) 440-2676

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center CurrentSince Apr 21, 2024 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Boone County Comprehensive Specialty Care CurrentSince Oct 13, 2025 Accepting new patients
Boone County Hospital CurrentSince Oct 13, 2025 Accepting new patients
Central States Medicine, PLLC CurrentSince Feb 12, 2020 Accepting new patients
Knoxville Community Hospital Inc CurrentSince Jan 1, 2026 Accepting new patients
Boone County Hospital CurrentSince Oct 13, 2025 Accepting new patients
Capital Orthopaedics and Sports Medicine LLP Past Accepting new patients

Locations

1015 Union St
Boone, IA 50036
Phone (515) 432-3140

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464

2425 Westown Pkwy
Ste 100
West Des Moines, IA 50266
Phone (515) 222-8346

6001 Westown Pkwy
West Des Moines, IA 50266
Phone (515) 224-1414

Interoperability endpoints

  • Direct secure messaging: bbolton132571@direct.unitypoint.org
  • Direct secure messaging: bbolton267330@uihcdirect.org
  • Direct secure messaging: bbolton3928233@direct.trinity-health.org
  • Direct secure messaging: betsy.bolton.1@19659.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19659/brand/1/csg/1/fhir/r4

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1144574997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 WESTOWN PKWY STE 100",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661425",
            "telephone_number": "515-267-1819",
            "fax_number": "515-401-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12499 UNIVERSITY AVE STE 210",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258288",
            "telephone_number": "515-440-2676",
            "fax_number": "515-440-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "BETSY",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002351",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "002351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.